NPI: 1629690821 · VERSAILLES, IN 47042 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 946 | $43K |
| 2021 | 2,759 | $110K |
| 2022 | 3,536 | $139K |
| 2023 | 3,366 | $138K |
| 2024 | 1,946 | $115K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 1,567 | 1,474 | $165K | |
| 92014 | 1,610 | 1,443 | $137K | |
| V2020 | Vision svcs frames purchases | 2,603 | 2,341 | $103K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,936 | 959 | $50K |
| 92015 | 3,450 | 3,164 | $42K | |
| V2100 | Lens spher single plano 4.00 | 756 | 548 | $18K |
| 92012 | 271 | 223 | $16K | |
| V2200 | Lens spher bifoc plano 4.00d | 185 | 82 | $7K |
| V2784 | Lens polycarb or equal | 96 | 82 | $3K |
| 99214 | 33 | 27 | $2K | |
| V2201 | Lens sphere bifocal 4.12-7.0 | 30 | 12 | $989.02 |
| 99213 | 16 | 13 | $980.00 |